Volunteer Application:
Name
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
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Austria
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Cayman Islands
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Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
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Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
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Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
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Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
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The Gambia
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Ghana
Gibraltar
Greece
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Guadeloupe
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Iran
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Laos
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Liberia
Libya
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Luxembourg
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Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
*
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Area Code
Phone Number
E-mail
How did you hear about us?
*
Please Select
Website
Social Media
Radio
Television
Word of mouth
Newsletter
School
Are you looking to volunteer one time, or ongoing?
*
One time
Ongoing
Not sure
If one time, please list the date:
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Month
-
Day
Year
Date
If ongoing, please list a date range (i.e. 5/15/20-12/10/20):
Do you need a specific number of hours, if so please enter below.
Emergency Contact Information:
*
Full Name
Contact Number
Relationship
1
2
Please list any limitations or requirements you may have so that we may accommodate you (i.e. allergies, medical conditions, physical limitations, etc.)
*
Availability: morning
Monday
Tuesday
Wednesday
Thursday
Friday
Availability: afternoon
Monday
Tuesday
Wednesday
Thursday
Friday
Availability: evening
Monday
Tuesday
Wednesday
Thursday
Friday
What area are you interested in volunteering? (You may select more than one)
Affordable Housing and Homeless Prevention/O'Reilly Center for Hope
Community and Neighborhood Development
Prevention and Youth Support
Early Childhood and Family Development
What specific skills and/or talents can you share with us? This will help us match volunteer opportunities to skills and interests (choose all that apply).
*
Marketing/promotion
Leadership
Public Speaking
Research
Facilitation/training
Fundraising
Direct Service
Other, please specify below.
Other
Have you completed a background check (within the last 12 months) prior to submitting this application?
*
Yes
No
I've got a current background check on file with another organization/business/school that I can share.
Would like to receive regular updates about CPO via our newsletter?
*
Yes
No
I grant CPO permission to use any photographs/video taken of me while I'm volunteering at CPO, in conjunction with the publicity of their programs/organization.
*
Yes
No
I don't know
By signing below, you are finalizing your volunteer application, releasing CPO from all liability including injury or damages sustained by any volunteer while participating in any CPO supported/sponsored event or activity, and acknowledging that you understand that all contact with the media whether print, television, radio, online or other shall be handled by CPO staff only. You agree that unless you are asked by CPO to be part of a story or feature, you are not permitted to talk, with or contact the media as a representative of CPO. You understand that failure to comply with this policy may result in dismissal as a CPO volunteer. Please sign and submit.
*
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